Oklahoma Supreme Court Says Medicaid Expansion Campaign Can Proceed

Jun 21, 2019
Originally published on June 24, 2019 6:36 am

A campaign to expand government health insurance to more low income Oklahomans overcame its first legal hurdle Tuesday. The Oklahoma Supreme Court ruled the effort can move forward just hours after hearing oral arguments.

Oklahoma is one of 14 states that has not expanded Medicaid under the Affordable Care Act. A group called Oklahomans Decide Healthcare hopes to change that by gathering enough signatures to put a constitutional amendment on the ballot in 2020.  

The summary, or “gist,” of the signature-gathering petition reads:

This measure adds a new Article to the Oklahoma Constitution. The new Article would expand Oklahoma’s Medicaid program to include certain low-income adults between the ages of 18 and 65 whose income does not exceed 133 percent of the federal poverty level, as permitted under the federal Medicaid laws.

The Oklahoma Council of Public Affairs, a conservative think tank, mounted a challenge in front of the state Supreme Court, calling the petition language “inaccurate” because a federal formula called an “income discregard” essentially stretches eligibility to 138 percent of the federal poverty level.

“That formula can and has already changed. It’s changed twice since the advent for the Affordable Care Act,” explained attorney Melanie Rughani, who represented the initiative-filers. “138 [percent] would be, frankly, inaccurate because the five percent income disregard could change tomorrow.”

OCPA also told the court that adding expanding Medicaid through the state constitution, rather than through statute, would strip the legislature of its spending power, making it unconstitutional.

Placing this right in the constitution transfers power from the state of Oklahoma to the federal government,” argued OCPA attorney Travis Jett. “The federal government gets to choose who is actually eligible for this program by setting the federal poverty level. Also Congress dictates how much Oklahoma actually pays by setting the federal matching level.”

Medicaid expansion would provide an estimated $900 million a year in federal money and cost the state over $100 million.

In a brief ruling, Chief Justice Noma D. Gurich said, “We believe the language of the gist is clear.” The ruling denied OCPA’s constitutionality arguments without explanation.


The petition to expand Medicaid needs nearly 178,000 signatures to get on the 2020 ballot. Amber England, the campaign manager for Oklahomans Decide Healthcare, says the group plans to start collecting in August.

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